FORM (SF)
255 / Architect—Engineer
and Related Services
Questionnaire for
Specific Project / Standard Form 255
General Services Administration
Washington, D.C. 20405
Fed. Proc. Reg. (41 CFR) 1-16.803
Armed Svc. Proc. Reg. 18-403
Purpose:
This form is a supplement to the “Architect-Engineer and Related Services
Questionnaire” (SF 254). Its purpose is to provide additional information
regarding the qualifications of interested firms to undertake a specific Federal
A-E project. Firms, or branch offices of firms, submitting this form should en-
close (or already have on file with the appropriate office of the agency) a cur-
rent (within the past year) and accurate copy of the SF 254 for that office.
The procurement office responsible for each proposed project may request
submission of the SF 255 (Architect-Engineer and Related Services Question-
naire for Specific Project” in accord with applicable civilian and military
procurement regulations and shall evaluate such submissions, as well as
related information contained on the Standard Form 254, and any other
performance data on file with the agency, and shall select firms for subsequent
discussions leading to contract award in conformance with Public Law 92-582.
This form should only be filed by an architect-engineer or related
services firm when requested to do so by the agency or by a public announcement.
Responses should be a complete and accurate as possible, contain data rela-
tive to the specific project for which you wish to be considered, and should be
provided, by the required due date, to the office specified in the request or
public announcement.
This form will be used only for the specified project. Do not refer to this sub-
mittal in response to other requests or public announcements.
Definitions:
“Architect-engineer and related services” are those professional services
associated with research, development, design and construction, alteration, or
repair of real property, as well as incidental services that members of these
professions and those in their employ may logically or justifiably perform,
including studies, investigations, surveys, evaluations, consultations, planning,
programming, conceptual designs, plans and specifications, cost estimates,
inspections, shop drawing reviews, sample recommendations, preparation of
operating and maintenance manuals, and other related services.
“Principals” are those individuals in a firm who possess legal responsibility
for it’s management. They may be owners, partners, corporate officers,
associates, administrators, etc.
“Discipline,” as used in the questionnaire, refer to the primary technological
capability of individuals in the responding firm. Possession of an academic
degree, professional registration, certification, or extensive experience in a
particular field of practice normally reflects an individual’s primary technical
discipline.
“Joint Venture” is a collaborative undertaking by two or more firms or
individuals for which the participants are both jointly and individually
responsible. / “Key Persons, Specialists, and Individual Consultants,” as used in this
questionnaire, refer to individuals who will have major project responsibility
or will provide unusual or unique capabilities for the project under
consideration.
Instructions for Filing (Numbers below correspond to
numbers contained in form):
1. Give name and location of the project for which this form is being submitted.
2. Provide appropriate date from the Commerce Business Daily (CBD) identi-
fying the particular project for which this form is being filed.
2a. Give the date of the Commerce Business Daily in which the project
announcement appeared, or indicate “not applicable” (N/A) if the source
of the announcement is other than the CBD.
2b. Indicate Agency identification or contract number as provided in the
CBD announcement.
3. Show name of the individual or firm (or joint venture) which is submitting
this form for the project.
3a. List the name, title, and telephone number of that principal who will
serve as the point of contact. Such an individual must be empowered to
speak for the firm on policy and contractual matters and should be familiar
with the programs and procedures of the agency to which this form is directed.
3b. Give the address of the specific office which will have responsibility for
performing the announced work.
4. Insert the number of personnel by discipline presently employed (on date
of this form) at work location. While some personnel may be qualified in several
disciplines, each person would be counted only once in accord with his or her
primary function. Include clerical personnel as “administrative.” Write in any
additional disciplines — sociologists, biologists, etc. — and number of people in
each, in blank spaces.
5. Answer only if this form is being submitted by a joint venture of two or more
collaborating firms. Show the names and addresses of all individuals or organi-
zations expected to be included as part of the joint venture and describe their
particular areas of anticipated responsibility (i.e., technical disciplines, adminis-
tration, financial, sociological, environmental, etc.).
5a. Indicate, by checking the appropriate box, whether this particular joint
venture has successfully worked together on other projects.
Each firm participating in the joint venture would have a Standard Form 254
on file with the contracting office receiving this form. Firms which do not have
such forms on file should provide same immediately along with a notation
Standard Form 255 July 1975
Prescribed by GSA Fed. Proc. Reg. (41 CFR) 1-16.803
STANDARDFORM (SF)
255 / Architect—Engineer
and Related Services
Questionnaire for
Specific Project / Standard Form 255
General Services Administration
Washington, D.C. 20405
Fed. Proc. Reg. (41 CFR) 1-16.803
Armed Svc. Proc. Reg. 18-403
regarding their association with this joint venture submittal.
6. If respondent is not a joint venture, but intends to use outside (as opposed
to in-house or permanently and formally affiliated) consultants or associates,
he should provide names and addresses of all such individuals or firms, as well
as their particular areas of technical/professional expertise, as it related to this
project. Existence of previous working relationships should be noted. If more
than eight outside consultants or associates are anticipated, attach an
additional sheet containing requested information.
7. Regardless of whether respondent is a joint venture or an independent firm,
provide brief resumes of key personnel expected to participate on this project.
Care should be taken to limit resumes to only those personnel and specialists
who will have major project responsibilities. Each resume must include: (a)
name of each key person and specialist and his or her title, (b) the project
assignment or role which that person will be expected to fulfill in connection
with this project, (c) the name of the firm or organization, if any, with whom
that individual is presently associated, (d) years of relevant experience with
present firm and other firms, (e) the highest academic degree achieved and the
discipline covered (if more than one highest degree, such as two Ph.D.’s, list
both), the year received and the particular technical/professional discipline
which that individual will bring to the project, (f) if registered as an architect,
engineer, surveyor, etc., show only the field of registration and the year that
such registration was first acquired. If registered in several states, do not list
states, and (g) a synopsis of experience, training, or other qualities which reflect individual’s potential contribution to this project. Include such data as: familiarity
with Government or agency procedures, similar type of work performed in the
past, management abilities, familiarity with the geographic area, relevant
foreign language capabilities, etc. Please limit synopsis of experience to directly
relevant information.
8. List up to ten projects which demonstrate the firm’s or joint venture’s
competence to perform work similar to that likely to be required on this project.
The more recent such projects, the better. Prime consideration will be given to
projects which illustrate respondent’s capability for performing work similar to
that being sought. Required information must include: (a) name and location of
project, (b) brief description of type and extent of services provided for each
project (submissions by joint ventures should indicate which member of the
joint venture was the prime on that particular project and what role it played),
(c) name and address of the owner of that project (if Government agency,
indicate responsible office), (d) completion date (actual or estimated), (e) total
construction cost of completed project, (or where no construction was involved,
the approximate cost of your work), and that portion of the cost of the project
for which the named firm was/is responsible. / 9. List only those projects which the A-E firm or joint venture, or members of
the joint venture, are currently performing under direct contract with an agency
or department of the Federal Government. Exclude any grant or loan projects
being financed by the Federal Government but being performed under contract
to other non Federal government entities. Information provided under each
heading is similar to that requested in the preceding Item 8, except for (d)
“Percent Complete.” Indicate in this item the percentage of A-E work completed
upon filing this form.
10. Through narrative discussion, show reason why the firm or joint venture
submitting this questionnaire believes it is especially qualified to undertake the
project. Information provided should include, but not be limited to, such data
as specialized equipment available for this work, any awards or recognition
received by a firm or individuals for similar work, required security clearances,
special approaches or concepts developed by the firm relevant to this project,
etc. Respondents may say anything they wish in support of their qualifications.
When appropriate, respondents may supplement this proposal with graphic
material and photographs which best demonstrate design capabilities of the
team proposed for this project.
11. Completed forms should be signed by the chief executive officer of the
joint venture (thereby attesting to the concurrence and commitment of all
members of the joint venture), or by the architect-engineer principal responsi-
ble for the conduct of the work in the event it is awarded to the organization
submitting this form. Joint ventures selected for subsequent discussions re-
garding this project must make available a statement of participation signed by
a principal of each member of the joint venture. ALL INFORMATION CON-
TAINED IN THE FORM SHOULD BE CURRENT AND FACTUAL.
Standard Form 255 July 1975
Prescribed by GSA Fed. Proc. Reg. (41 CFR) 1-16.803
OMB Approval No. 29-R0235
STANDARDFORM (SF)
255
Architect-Engineer
Related Services
for Specific
Project / 1. Project Name/Location for which Firm is Filing:
Indefinite Quantity Contract for A & E services in Caribbean / 2a. Commerce Business
Daily Announcement
Date, if any:
6/01/04 / 2b. Agency Identification
Number, if any:
3. Firm (or Joint-Venture) Name & Address
Jaca & Sierra Testing Laboratories
PO Box 363116
San Juan, PR 00936-3116 / 3a. Name, Title & Telephone Number of Principal to Contact
Ruben Torres, President
3b. Address of office to perform work, if different from Item 3
4. Personnel by Discipline:
5 / Administrative / Electrical Engineers / Oceanographers
Architects / Estimators / Planners: Urban/Regional
Chemical Engineers / 1 / Geologists / Sanitary Engineers
Civil Engineers / Hydrologists / 7 / Soils Engineers
Construction Inspectors / Interior Designers / Specification Writers
1 / Draftsman / Landscape Architects / Structural Engineers
Ecologists / Mechanical Engineers / Surveyors
Economists / Mining Engineers / Transportation Engineers / Total Personnel 55
5. If submittal is by Joint-Venture list participating firms and outline specific areas of responsibility (including administrative, technical and financial) for each firm:
(Attach SF 254 for each if not on file with Procuring Office.)
5a. Has this Joint-Venture previously worked together? yes no
Standard Form 255 July 1975
Prescribed by GSA Fed. Proc. Reg. (41 CFR) 1-16.803
6. Outside Key Consultants/Associates Anticipated for this Project (Attach SF 254 for Consultants/Associates Listed, if not already on file with the Procuring Office)Name & Address / Specialty / Worked with Prime before (Yes or No)
1)
2)
3)
4)
5)
6)
7)
8)
Standard Form 255 July 1975
Prescribed by GSA Fed. Proc. Reg. (41 CFR) 1-16.803
a. Name & Title:
CARLOS A. PEREZ RODRIGUEZ, P.E. PARTNER / a. Name & Title:
RUBEN TORRES, P.E., PRESIDENT
b. Project Assignment:
GEOTECHNICAL ENGINEERS / b. Project Assignment:
GEOTECHNICAL ENGINEER
c. Name of Firm with which associated:
JACA & SIERRA TESTING LABORATORIES / c. Name of Firm with which associated:
JACA & SIERRA TESTING LABORATORIES
d. Years experience: With This Firm / 25 / With Other Firms / 0 / d. Years experience: With This Firm / 28 / With Other Firms
e. Education: Degree(s) / Year / Specialization
BS 1970 CIVIL ENGINEER / e. Education: Degree(s) / Year / Specialization
BS 1968 CIVIL ENGINEERING
f. Active Registration: Year First Registered / Discipline
1975 PROFESSIONAL ENGINEER / f. Active Registration: Year First Registered / Discipline
1975 PROFESSIONAL ENGINEER
g. Other Experience and Qualifications relevant to the
proposed project:
Eng. Carlos A. Perez has 15 years of experience in geotechnical engineering
work in laboratory testing material and earthwork supervision.
Eng. Perez directs and performed geotechnical studies of bridgesstructures,roads,
tanks, trunk sewer, sanitary waste and filtration tank, housing project, industrial
development , commercial center, high rise structures, public and governmental
projects.
These geotechnical strudies have made included evaluations, parameters and
recommendations for design and construction of related structures and substructures
using shallow and deep foundation systems. / g. Other Experience and Qualifications relevant to the proposed project:
Eng. Ruben Torres has 28 years experience in geotechnical engineering, including
material laboratory testing and earthwork supervision.
Eng. Torres have been involved in geotechnical studies for various projects in the island of P.R., including supervision, evaluation and recommendations. He also was soil and material testing laboratory director for over ten years.
His experience includes geotechnical services for buildings, residential developments, highways, commercial structures and earthworks supervision for the
projects.
Standard Form 255 July 1975